Rapid Development of Cefiderocol Resistance in Carbapenem-resistant Enterobacter cloacae During Therapy Is Associated With Heterogeneous Mutations in the Catecholate Siderophore Receptor cirA.

Sabrina Klein,Sébastien Boutin,Kaan Kocer,Mascha O Fiedler,Dominic Störzinger,Markus A Weigand,Benjamin Tan,Daniel Richter,Christian Rupp,Markus Mieth,Arianeb Mehrabi,Thilo Hackert,Stefan Zimmermann,Klaus Heeg,Dennis Nurjadi

CLINICAL INFECTIOUS DISEASES（2022）

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摘要

We report a case of resistance development toward cefiderocol in a patient with intra-abdominal and bloodstream infections caused by carbapenemase-producing Enterobacter cloacae within 21 days of cefiderocol therapy. Whole genome sequencing revealed heterogeneous mutations in the cirA gene, encoding a catecholate siderophore receptor, conferring phenotypic resistance to cefiderocol.

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关键词

antibiotic resistance, carbapenemase, Cefiderocol, cirA siderophore receptor, Enterobacter cloacae

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